The present invention relates to an orthopedic device for treating hip displeasure and hip luxation.
Devices of the above-mentioned general type are known in the art and known orthopedic device for treating hip displeasure or hip luxation has a pelvic basket and two thigh holders each mounted on one end of a thigh-guiding member whose other end is pivotally connected with the pelvic basket. Such a device is disclosed, for example, in the German Auslegeschrift No. 2,714,272. The pelvic basket in this device is considerably raised in its lateral regions and has at its lower end a spreading web with an upwardly expanding projection shaped as a bracket whereby a thigh opening is formed in the lower region of the pelvic basket. A belt with a burdock-type lock is connected with the pelvic basket at its upper end. Thigh-guiding members are pivotally mounted at the side of the pelvic basket with the aid of a screw which simultaneously forms the axis of rotation of the thigh-guiding member. Because of this pivotability, a child can bring the bone to a suitable position for walking, crawling and lying.
The thigh-guiding members are composed of two flat bars which are displaceable in longitudinal direction relative to one another and fixable in a stepless manner to one another. Thereby the guiding members are longitudinally adjustable in a stepless manner and can be adjusted in dependence upon the thigh length of the patient. Mounting means of the thigh-guiding members and therefore the axes of rotation of the latter are located above the so-called thigh openings, whereas both axes of rotation are approximately in alignment with one another. The thigh-guiding members are bent with an obtuse angle of approximately 180.degree., so that they intersect a straight line of the sagittal plane of the pelvic basket located in the longitudinal axis of the thigh-guiding members in immovable position, at an angle .alpha. of approximately 35.degree.. The spreading angle holds the abduction of 35.degree. during bending from zero to 90.degree..
Treatment of hip displeasure and hip luxation in newborns is performed in two phases. The first phase includes reposition of the hip joint head or the head core (in the originally formed joint head) into the seat. The second phase includes retention, i.e. fixing of the corrected joint head in position which is favorable for maturing of the joint. The retention is performed mainly by fixation of the bone with a gypsum bandage in a position prescribed by a physician. For a long time the experts were concerned with determination of an angular position which is optimal for curing of the hip joint. Despite extensive clinical and experimental research, they are still far from a uniform treatment technique. As before, the value of the angle selected for retention as well as the position of the bones are controversial. Research has shown that after long fixation of an extremity in the gypsum bandage, irreversible damage takes place not only on bones, but also in muscles, vains and ligaments. It has been recognized that these damages are seldom attributable to the gypsum bandage itself, but more often are attributed to the bone holders which receive the gypsum bandage, particularly because of the strong staying. There were also attempts during reposition and retension of the hip joints to reduce the duration in the gypsum bandage and to avoid the regidity of the fixation of the same. For this purpose, numerous casts and bandages were developed. Designers and physicians provide information about many achievements in this field. The only conclusion which can be drawn from this is that the correct bone position during the reposition as well as the retension is different from case to case, so that the treatment is performed not in a standard position but instead in an individually determined position of bones. In addition, all known casts and bandages allow more or less only a certain treatment position and thereby narrow the treatment posibilities of the physician in very disadvantageous manner for the patients.
U.S. Pat. No. 3,068,862 discloses a spreading device which makes possible only one independent from a physician and very strong spreading position of the child's bones. A comparable device is disclosed also in the German Auslegesschrift No. 1,263,219. A substantially flexible construction is described in the German Offenlegungsschrift No. 2,018,240. The starting point of the present invention is the above-mentioned German Auslegesschrift No. 2,714,272. In this reference the thigh-guiding members or casts are pivotably articulately connected on the pelvic basket. However, the pivoting is performed exclusively about fixed and aligned pivot axes, so that the above-mentioned abduction is always held with an angle of 35.degree.. The treating physician has no possibility to change the spreading position during the treatment in a stepless manner. There is also the disadvantage that the thigh-guiding members are freely pivotable. Arresting and/or limiting of the pivotable movement within a predetermined angular region is not possible. Another disadvantage is the arrangement of both pivot axes so that they are not located in the region of the natural hip joint. The spreading device does not allow arrangement of the shank-guiding members with their respective shank holders. Because of the raised-up lateral regions of the pelvic basket, as well as the spreading web provided at its front side, lying of the child, particularly for changing diapers or clothes is very difficult. Because the spreading web is arranged on the front side of the pelvic basket, a certain spreading position of the bone of the patient is predetermined with this spreading device, so that in the sense of this basic disadvantage this device does not differ from the above-mentioned constructions. Comparative tests have shown that animals including babies, can be subdivided into two groups in dependence upon the birth conditions: those tending to remain in a nest and those tending to leave the nest. The first group is at a lower organization stage, whereas the second group belongs to a higher organization and the brain of the babies of the second group is completely developed. Because of its highly developed brain, the man must be qualified as belonging to the animals with a tendency to leave the nest. However, it is not the case. The reasons for this is that with its nine months he still has to be considered as prematurely born and first matures to be one having the tendency to leave the nest only after the following twelve months. After the birth, mother and child forms a similar biological unity as during the pregnency. As a result of this, the organs which have not matured in the mother's womb, for example the hip joint, must be retained in a position similar to the position of these organs in pre-birth conditions in order to complete the process of maturing without distortions. When this does not take place, outer medhanical influences on immature hip joints can dislocate them.
These views can also be proved by research in anthropology. During the tribal time of the human history, mothers carried their children on their bodies which is also known today in many nations. Hip luxation is extremely seldem there. Since in natural conditions of babies, the mother and not the baby has a channel forming the only surrounding of the child, a holding apparatus for bones must be adapted to life on the mother's body. This is defined by Doctor Fettweis as sit-squat position for treating the hip displeasure and hip luxation in connection with a gypsum bandage.